1

1.5
1.5.2

HEALTH SERVICES DELIVERY

PROGRAMME FOR VULNERABLE POPULATIONS
Health o El!e"# DDG (PHS) Director YEDD , HEB, NCD, NIHS, of the Ministry of Health, PDHSs and the DPDHSs and other sectors Elders and their family mem ers and the comm!nity

A Fo$al Po%&t B I'(le'e&t%&) A)e&$%e# C Ta")et A"ea# * Be&e %$%a"%e#

P"o+e$t S,''a"-.

"ith Sri #an$a enterin% into the final sta%e of the Demo%ra&hic 'ransition, the &ro&ortion of elderly is increasin% as ne(er efore, By year )*+* it is e,&ected that there -ill e a o!t +* . of elderly &o&!lation in the co!ntry -hile this -ill increase to a o!t )* . y the year )*)*/ Hi%her &ro&ortions of elderly create se(eral challen%es for a health system in terns of increased in&!ts/ It is elie(ed that the increasin% incidences and &re(alences of se(eral non0 comm!nica le diseases are the res!lts of the &o&!lation a%ein%/ Ho-e(er altho!%h the elderly are loo$ed after y the ro!tine health care deli(ery system it is im&ortant to ma$e the system more amena le to the deli(ery of ser(ices for the s&ecific tar%et %ro!&/ It is &ro&osed that the system -ill e fine0t!ned to address the most &ressin% needs of the elderly in the years to come/ 'his &ro1ect is desi%ned -ith the o 1ecti(e of im&ro(in% the 2!ality of life of elderly thro!%h health &romotion, &re(ention treatment and reha ilitation/

1. /,#t% %$at%o&. 3t &resent the elderly &o&!lation (o(er si,ty years) in Sri #an$a to nearly t-o million or +*. of the total &o&!lation/ 3mon% them a lar%e n!m er s!ffer from &hysical and social health &ro lems/ Most elders in o!r society lac$ ade2!ate $no-led%e re%ardin% the ty&e of illnesses they are li$ely to s!ffer d!rin% old a%e/ Most hos&itals in o!r co!ntry do not ha(e a system for %i(in% &references to elders at the 4PD or dis&ensary5 -hich means they ha(e to -ait in the same lon% 2!e!e as others/ 6or the elders -ho !s!ally seem to ta$e se(eral $inds of medicine for the n!m er of illnesses they s!ffer from, it is !nli$ely that they -o!ld e ta$in% the dr!%s &ro&erly if the Pharmacist does not s&end eno!%h time in e,&lainin%/ "ithin the Pre(enti(e Health Care Pro%ramme screenin% clinics are not held for elderly to dia%nose the common illnesses early/ 3s s!ch the com&lications -o!ld set in d!e to delay in ta$in% treatment/ 3 &atient -ith !ndetected hi%h lood &ress!re -ith hardly any sym&tom -ill s!ddenly end !& in the hos&ital -ith a stro$e or die efore admission/ 6or most of the elders -ho s!ffer from chronic illnesses they need life lon% treatment/ 3s a res!lt the n!m er of &atients attendin% the s&ecialist clinics to %et the monthly 2!ota of dr!%s $ee&s on increasin% in s&ite of the fact at there are se&arate clinics held for Hi%h lood

&ress!re, dia etes, heart disease, 1oint &ains, cancer, mental illness etc in most ma1or hos&itals/ Some of the &atients tra(el a lon% distance y&assin% a n!m er of hos&itals to attend these clinics (sometimes only to %et the lood &ress!re chec$ed and collect the monthly medicine) 2. I'(o"ta&t A##,'(t%o&#0R%#1#0Co&!%t%o&#. 'he Pro(inces -ill fall in line -ith the &olicies of the Ministry of Health 2. P"o+e$t O3+e$t%4e. O3+e$t% 4e I& !% $a to "# Me a&# o Ve" % %$ at%o & 8!arterly ret!rn (9*:); Ne- MIS S&ecial s!r(eys (2!alitati(e, 2!antities)

'o im&ro(e the 2!ality of life of 8!ality of life elderly thro!%h &ro(ision of indicators s!&&orti(e en(ironment, im&ro(ement of the facilities for health &romotion, disease &re(ention 7 reha ilitation 5. P"o+e$t O,t(,t0P"o!,$t. O,t(,t # I& !% $a to "#

National De(elo&ment of a &lan of national &lan of action action de(elo& ed ased on national health &olicy for im&ro(i n% &re(enti

M ea &# o Ve "% %$a t%o & 'he a(aila ility of the national &lan of action

O,t(,t #

I& !% $a to "#

M ea &# o Ve "% %$a t%o &

(e, c!rati(e and reha ilit ati(e health ser(ices facilities made a(aila l e for health &romoti on of elders Care for elderly incl!ded in the &re ser(ice c!rric!l a medical, n!rsin% and &aramed ical c!rric!l a 'he comm!nity and health made a-are of &ro lems related to elderly care

N!m er of facilities !nderta$in% health &romotion of elders

<e&orts from facilities

N!m er of c!rric!la s!&&lemented -ith the elderly care mod!le

<e&orts

N!m er of facilities carryo!t s&ecial reha ilitation &ro%rammes for elders

<e&orts from facilities

5. Relate! P"o+e$t#. P"o+e$t T%tle Inte%rated health care for the elders

Promotion of health and &re(ention disa ility amon% older &ersons

of

6. Rele4a&t A)e&$%e# to 3e Coo"!%&ate!. #ine and &ro(incial Ministries of Health, Director YEDD;HEB ; 6HB; NIHS; Po&!lation Di(ision; S'D 3IDS Cam&ai%n, M4Hs and Medical Instit!tions, Ministry and De&artment of Social Ser(ices, Ministry of yo!th 3ffairs and S&orts, NYSC, Ministry and De&artment of Ed!cation, Hel&3%e Sri #an$a and other NG4, de&artment of #a o!r, "omen=s B!rea!, Ministry of >!stice, Ministry of media and Information, ?ni(ersities and de(elo&ment Partners/ 7. Mo&%to"%&) * E4al,at%o&. +/ "ho@ Secretary, Ministry of Health, DGHS, DDG;PHS

)/ "hen@ 8!arterly, 3nn!ally A/ "hat actions to e ta$en ased on res!lts of monitorin% 7 e(al!ation@ Im&ro(ed &lannin% and &ro(ision of ser(ices ased on the identified %a&s/ 'he acti(ities -ill e modified ased on the findin%s of the e(al!ation/ 8. A$t%4%t%e#. A$t%4%t%e# E P " o $ e # # I & ! % $ a t o " # Cond!ct a Needs 3ssessment amon% elders and amon% I d e n t i

instit!tions that can e !tiliBed for the &ro%ramme

f y t h e a s s e s s m e n t t e a m D e ( e l o & ' 4 < I d e n t i f y a c o r e % r

6orm!late the National Policy and 3ction Plan on older &ersons

'

o ! & D e ( e l o & t h e ' 4 < D e ( e l o & n o r m s a n d s t a n d a r d s I d e n t

Identify and create cadres for all le(els ased on the &olicies and standards

'

i f y r e 2 ! i r e d c a d r e I d e n t i f y r e s e a r c h & r i o r i t i e s I d e n

Carryo!t research to fill in the $no-led%e %a&s

<

t i f y r e s e a r c h e r s I d e n t i f y s t a $ e h o l d e r s D e ( e l o & t h e '

De(elo& a for!m to colla orate -ith other %o(ernment and non0 %o(ernment or%aniBations

Cond!ct a series of ad(ocacy; a-areness &ro%rammes amon% &olitical leaders, &olicy ma$ers, administrator s, health staff and comm!nity on health of elderly

4 < I d e n t i f y n e e d s f o r a a r e n e s s D e ( e l o & t h e & r o % r a m m

e I d e n t i f y t a r % e t a ! d i e n c e s De(elo& a mod!le for trainin% and ed!cation of medical, n!rsin% and &ara0medical &ersonal on care of elderly and introd!ce into the c!rric!l!m 3 I d e n t i f y t r a i n i n % n e e d s D

e ( e l o & t h e m o d ! l e s N e % o t i a t e i t h H e a d s ; D e a n s o f t r

a i n i n % s c h o o l s S e l e c t t h e s c r e e n i n % f a c i l i t i e s t o e

Pro(ide screenin% facilities for selected diseases for elders in selected le(els of hos&itals

e , & a n d e d S e l e c t t h e l e ( e l o f h o s & i t a l s 3 s s e s s t h e n e

c e s s a r y e 2 ! i & m e n t ; f ! n d s < e l e a s e c i r c ! l a r s 3 & & o i n t a -

De(elo& %!idelines s&ecifyin% 2!ality c!rati(e care for elders in state hos&itals

o r $ i n % % r o ! & D e ( e l o & t h e ' 4 < I d e n t i f y t h e n e e d I d e n t i

6acilitate the trainin% of carers for increasin% elderly &o&!lation

'

f y h o M o H c a n a s s i s t i n t h i s a r e a Esta lish facilities in the comm!nity for health of elderly incl!din% day centres, lon% stay hos&itals C I d e n t i f y h a t f a c

i l i t i e s a r e n e e d e d I d e n t i f y l o c a t i o n o f f a c i l i t i e s

Esta lish a mechanism to assist elderly and disa led to contin!e reha ilitation at the time of dischar%e from hos&itals;inst it!tions

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D e s i % n t h e m e t h o d D e ( e l o & f o r m s a n f o r m a t s

Stren%then the !nit of D;YEDD

I d e n t i f y

a r e a s f o r s t r e n % t h e n i n % D e ( e l o & a & r o & o s a l I d e n t i f y

Esta lish a Mana%ement Information system in relation to elderly health

d a t a f i e l d s , D e ( e l o & t h e m e c h a n i s m P i l o t t h e m e c h a n i

s m